Document: June 1 deadline for states joining HealthCare.gov - House to vote on revamped expat bill

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DOCUMENT: JUNE 1 DEADLINE FOR STATES JOINING HEALTHCARE.GOV — If states want to scrap their failing exchanges and join the federal system, they have to submit a blueprint to the Obama administration by June 1, according to a report posted Monday on the website of Nevada’s exchange. The state is thinking about joining HealthCare.gov, and its consultant — Deloitte — noted that the switch would require submitting details to the Obama administration in just over a month. It’s unclear if the deadline is based on formal federal guidance, but it’s the first indication that there’s any structured process in place. Deloitte also notes that Nevada may require additional funding to make the transfer to HealthCare.gov and that the feds may not have the “capability” to absorb the state’s system. http://1.usa.gov/1pIirbZ

--STATES WITH EXCHANGE FLOPS DECIDING WHETHER TO HOLD OR FOLD — Was Oregon the first domino to fall? Other states with faulty exchanges are weighing whether to become the next to scrap their systems and join the federally run HealthCare.gov. Massachusetts, Nevada and Maryland have all given varying levels of consideration to dropping their multi-million-dollar efforts in favor of the federal system, and their decisions may be coming soon. On the flip side, few states are looking at dropping out of HealthCare.gov and building their own systems, even though Obamacare’s framers initially envisions that many — if not most — would go off on their own. The latest look at the landscape: http://politico.pro/1rGaUYK

Good Tuesday morning and welcome to PULSE, where we’d like to welcome Pro Health’s newest sibling, eHealth into the POLITICO family. Arthur Allen, a veteran policy and science reporter will take the reins of the vertical today and soon be joined by David Pittman of MedPage Today and Ashley Gold of FierceMarkets HealthIT.

“The TV, she talks to me, breaking news and building PULSE.”

HOUSE TO VOTE ON REVAMPED EXPAT BILL-- The House is due to vote today on a bill to alter how the health law treats expatriates and the insurers who cover them. The House voted earlier this month on a similar bill but it did not pass amid strong opposition from Democrats and the White House (and a Republican decision to try to quickly pass the bill under a method that requires two-thirds support). The bill's sponsors — Democratic Rep. John Carney and Republican Rep. Devin Nunes — altered the bill since then to address Democrats' concerns that the bill created large loopholes. While one significant change was made — the definition of expatriate was increased to someone who spends six months or more outside of the country — other loopholes remain that would allow insurers to game the system, sources say. Democrats and White House allies were still trying to alter the bill as it went before the House Rules Committee last night, but the bill was sent to the House floor under a closed rule, meaning that the bill cannot be amended on the floor. It is expected to pass today with Republican support.

BURWELL’S FIRST CONFIRMATION HEARING SCHEDULED — The Senate will get its first crack at Sylvia Mathews Burwell next week, when the HELP Committee holds a 10 a.m. confirmation hearing. The committee won’t get a vote, but members will get an unbridled opportunity to grill the president’s nominee to succeed Kathleen Sebelius as HHS secretary. Burwell, who runs the Office of Management and Budget, will also be interviewed by the Senate Finance Committee at a to-be-determined date. That committee will ultimately vote on sending her nomination to the floor. White House spokesman Jay Carney has predicted a May transition.

KAISER POLL: AMERICANS DOWN ON OBAMACARE ENROLLMENT TARGETS — Americans were nonplussed by Obamacare’s enrollment surge at the end of March, according to new Kaiser Family Foundation tracking poll that found most people thought the law missed its sign-up goals. But respondents also recorded strong support for the law’s contraception coverage mandate for most businesses. Pro’s Sarah Wheaton reports: “Among those who remain uninsured despite the individual mandate, the poll found that 36 percent shopped for health insurance but decided that the plans available were too expensive.” http://politico.pro/1hNKIno

--DEM POLL: OBAMACARE ANTIPATHY FADING – But that doesn’t mean Democrats should necessarily run on a pro-ACA platform, said Stan Greenberg, who conducted the poll released Monday by Democracy Corps. The Democrat-aligned organization noted that independents in swing districts largely prefer fixing the health law while implementing it rather than repealing it altogether. Likewise, hatred for the law waned among Republicans, although they still predominantly despise it. The poll was conducted from April 10-15 among 1,250 likely midterm voters in 50 competitive Republican districts and 36 competitive Democratic districts. http://politico.pro/1k69dOf

APPEALS COURT CONSIDERS MISSISSIPPI ABORTION STATUTE — A fight over abortion and women’s health played out Monday in the 5th Circuit Court of Appeals, where a three-judge panel is considering whether a Mississippi statute would unconstitutionally force the state’s only abortion clinic to shut down. The Associated Press reports that an attorney for the clinic, Jackson Women’s Health Organization, argued the state law — which requires doctors at abortion clinics to be able to admit patients to local hospitals — was really intended to end abortion in the deep red state. Although a similar law in the same court was recently upheld in Texas, the judges in that case weren’t considering whether the law would shutter the state’s only clinic. Lawyers arguing on behalf of the Mississippi law contended it was intended to protect women’s health, not ban abortion in the state altogether. http://abcn.ws/1j9zGxt

** AbbVie Takes on Toughest Health Challenges **

--OBAMACARE GETS ANOTHER DAY IN COURT TODAY – The D.C. District Court will hear arguments on a procedural attempt to undo Obamacare. This one revolves around the Origination Clause — essentially a constitutional requirement that tax-raising bills originate in the House. The Senate hollowed out an unrelated spending bill delivered by the House and inserted its Obamacare text, effectively circumventing the requirement by using a time-honored procedural maneuver. But that process has never been challenged in court. Few expect the outcome to actually undermine the law, but it’s another chance for opponents to attempt to take a swipe at it in the courtroom. The Pacific Legal Foundation is bringing the suit: http://bit.ly/1fqEnDN

PULSE SCOOPLET: FORMER HHS OFFICIAL TO HEAD CVS GOVERNMENT TEAM — Sol Ross, a former director of private sector engagement in HHS’s external affairs office, will lead CVS’s efforts to influence federal policy, the company plans to announce. Ross was HHS’s liaison to the business community during implementation of the ACA, and he previously worked as a consultant to state and local governments.

--SENIOR CMS OFFICIALS JOINS APPLIED POLICY — John Voorhees, an 11-year veteran of CMS, has joined Applied Policy, a health care consulting firm based in D.C. Voorhees was the agency’s chief administrative officer and oversaw contracting awards. He also advised senior officials during implementation of the Medicare Modernization Act.

WHAT WE’RE READING, by Paige Winfield Cunningham

A new Washington Post-ABC News poll suggests Americans are more inclined to believe Obamacare implementation got worse in the months following its disastrous rollout: http://wapo.st/1tY1aee

The Wall Street Journal looks at the “no man’s land” for cancer patients — those between ages 15 and 24 who haven’t seen the gains in survival rate that younger and older patients have: http://on.wsj.com/1hMfdu6

An orthopedic surgeon opines in the WSJ that mandates on doctors are sapping morale in the profession and must be stopped: http://on.wsj.com/1pItzFN